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Dr Rinds Journal

As you have read on my previous blog and information on this site, breast thermography is an excellent tool for preventive breast health. Unlike mammography, whose function is to detect a tumor after it has already formed and grown big enough to be seen by the mammograpn (typically 1-2 years), the function of the breast thermogram is to allow prediction on risk of breast cancer. It shows changes typically associated with the formation of cancers. Thus, the clinical use of breast thermography is preventive (allows you to take action before the cancer) while mammography is corrective (take action after the cancer is already there).

The thermogram is rated according to risk (level 1 to 5) with levels 1 and 2 yielding a 99% confidence that there is no breast cancer present. A level 5 risk suggests a 90% risk of cancer already present (even if it just recently started and is microscopic). As the pattern suggestive of declining breast health evolves and becomes more pronounced, the risk level rises. Another way of looking at this is that the pattern shows a gradual decline in breast health, i.e., statistically getting closer to having cancer. Similarly, if no change is taking place year after year, this suggests a stable breast health condition. It is always nice to know that no new vessels or hot spots are developing.

It is even more rewarding to see that the pattern is improving suggesting that whatever is being done is (statistically) reducing the risks. With 1 in 8 women at risk for breast cancer, it is comforting to know that what we are doing is helping our health. We don’t have to be sitting ducks waiting for bad news. It’s a great feeling to know we can have some visibility and control here.

Thus, the added uses of thermography are:

·Monitoring breast health

·Monitoring changes (improvement as well as decline) in breast health

·Monitoring for adverse changes after treatment of breast cancer

·Monitoring to see if the breast health program is working (i.e., is the pattern appearing like a healthier one or is it evolving into a higher risk pattern)

·Helping to monitor hormone replacement therapy (see below)

Another interesting use for the breast thermogram is to help monitor hormone replacement therapy. When estrogen dominance is present (an imbalance of estrogen and progesterone which favors a stronger estrogenic expression), we begin to see a pattern suggestive of higher risk. I use this to help me adjust the dosages so that the thermographic image remains as healthy as it can. At times, I even see a healthier appearance after starting the HRT (I only use bio-identical hormones). If the thermogram starts to look ‘worse’, I adjust the hormone level down until it looks healthy again.

It is imperative that a high resolution camera be used (at least 80,000 pixels) and both colorized as well as grey scale be depicted. The color shows regional heat patterns while the grey scale is excellent for demonstrating vascular patterns.

In the next blog, I’ll describe some of the methods I use for improving breast health. This approach tends to make the breast tissue more uniform and less lumpy as well as tending to make the thermographic image healthier looking. The advantage of the thermogram is that if the image does not appear to be getting healthier, we try a different approach until we (hopefully) find what does work to improve breast health.

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Many women are concerned about the recent recommendations to limit mammography to women over age 50. On November 16th, the U.S. Preventive Services Task Force (USPSTF), an independent panel of doctors and scientists that make recommendations to the U.S. Department of Health and Human Services, announced a change in their mammography screening guidelines. The new guidelines recommend several changes. The most controversial change was that screening mammograms be taken every 2 years for women age 50-74 versus their old guidelines which recommended screening mammograms every 1-2 years starting at age 40.

This may actually be a blessing in disguise since women might now be motivated to look at other options. There is an option which is non-invasive and very accurate. Thermography! Thermography looks at a woman’s risk for developing cancer (i.e., best use of thermography is before the problem) while mammography is used for identifying a problem after it is present and has been there long enough to start becoming visible. If these technologies were to be compared to working with the weather, then a thermogram would tell you what the chance of rain is and if over time the weather is getting better or worse. The mammogram would be there to tell you how many inches it already rained. In other words, the thermogram is best used in the ‘preventive’ mode (before the cancer comes) while the mammogram is best used in a ‘corrective’ mode (it only begins to give information about a cancer once the cancer is there). Each has a different purpose. A colleague of mine put it this way, “using a mammogram for preventive care is like trying to drive forward by using the rear-view mirror”. Similarly, using a thermogram to image a tumor is not an appropriate use of that technology. The assessment for tumor location and size would be obtained with a mammogram, ultrasound or MRI.

In a car analogy, the thermogram is there to let you know that a rough road is coming up, likelihood of potholes etc. and provide time to make a course change. The mammogram lets you know how big the pothole was that you already hit.

An additional benefit to thermography is that it is a sensitive indicator of change in the vascularity and general health appearance of the breast. It can show increased/decreased vascularity (see the grey scale images above), thermal symmetry or new hot spots that were not there before. It can show unhealthy changes in the breast years before a cancer forms in that breast. This allows for monitoring of those changes in response to health and lifestyle changes. If the right things are being done, then we see an image indicative of a healthier breast.

It is important to remember is that not all thermographic equipment is equal. The resolution should be no less than 80,000 pixels. Also, the unit should be able to not only take color but also black and while thermal images. The color images are best for demonstrating regional differences and changes while black and white image is much better for seeing the vascular patter (See example below). Each has a different but equally important function.

It is also important to work with a doctor knowledgeable in breast health improvement.